Head and Neck Cancers
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Head and neck cancers are malignancies arising in the upper aerodigestive tract (this includes: lip, tongue, salivary glands, mouth, oropharynx, nasopharynx, hypopharynx, nasal cavity, and larynx). Laryngeal (voice-box) cancer is the most frequent type, accounting for about a quarter of head and neck cancers.

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Laryngeal Cancer
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Molecular Biology of Head and Neck Cancers
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Latest Research Publications

Head and Neck Cacer Resources (16 links)

Latest Research Publications

This list of publications is regularly updated (Source: PubMed).

Wagle N, Grabiner BC, Van Allen EM, et al.
Response and acquired resistance to everolimus in anaplastic thyroid cancer.
N Engl J Med. 2014; 371(15):1426-33 [PubMed] Related Publications
Everolimus, an inhibitor of the mammalian target of rapamycin (mTOR), is effective in treating tumors harboring alterations in the mTOR pathway. Mechanisms of resistance to everolimus remain undefined. Resistance developed in a patient with metastatic anaplastic thyroid carcinoma after an extraordinary 18-month response. Whole-exome sequencing of pretreatment and drug-resistant tumors revealed a nonsense mutation in TSC2, a negative regulator of mTOR, suggesting a mechanism for exquisite sensitivity to everolimus. The resistant tumor also harbored a mutation in MTOR that confers resistance to allosteric mTOR inhibition. The mutation remains sensitive to mTOR kinase inhibitors.

Related: Thyroid Cancer Everolimus (Afinitor)

Kuo P, Chen MM, Decker RH, et al.
Hypopharyngeal cancer incidence, treatment, and survival: temporal trends in the United States.
Laryngoscope. 2014; 124(9):2064-9 [PubMed] Related Publications
OBJECTIVES/HYPOTHESIS: The objective was to characterize incidence, treatment, and survival for hypopharyngeal cancer in the United States between 1988 and 2010, and to analyze associations between changes in treatment modality and survival.
STUDY DESIGN: Retrospective cohort study.
METHODS: A total of 3,958 adult patients with hypopharyngeal cancer were identified in the Surveillance, Epidemiology, and End Results database. Incidence, treatment, and survival, controlling for patient demographics and disease severity, were analyzed using two-tailed t tests, Kaplan-Meier analysis, and univariate and multivariate Cox regression.
RESULTS: The incidence of hypopharyngeal cancer decreased from 1973 to 2010 with an average annual percent change (APC) of -2.0% every year (P < .05). Treatment with laryngopharyngectomy decreased (-2.5% APC, P < .001), treatment with radiotherapy without surgery increased (+2.0% APC, P < .001), and treatment with neither surgery nor radiotherapy increased (+0.5% APC, P < .001) between 1988 and 2010. There was a significant increase in the 5-year overall survival between 1988 and 1990 and between 1991 and 1995 (P = .024) with no other significant temporal trends in survival. Multivariate analysis revealed that age (65-74, 75-84, or 85+ relative to 18-54 years old), race (white relative to non-African races), T stage (T2, T3, or T4 relative to T1), N stage (N2 or N3 relative to N0), and treatment modality (-surgery/-radiation, -surgery/+radiation, and +surgery/-radiation relative to +surgery/+radiation) were all significantly associated with worse survival.
CONCLUSIONS: Hypopharyngeal cancer has had a decreasing incidence with little change in patient or tumor characteristics. Treatment has increasingly involved radiation without laryngopharyngectomy. This has not been associated with a decrease in survival. Controlling for patient demographics and disease severity, radiation with laryngopharyngectomy is associated with improved survival.

Related: Hypopharyngeal Cancer USA

Rammeh S, Fazaa B, Ajouli W, et al.
Papillary haemangioma: a case report of multiple facial location.
Pathologica. 2014; 106(2):67-9 [PubMed] Related Publications
Papillary haemangiomas were recently defined as morphologically distinct and benign cutaneous haemangiomas showing a predominantly intravascular capillary proliferation within dilated thin-walled dermal blood vessels. We describe the case of a 45-year-old woman who presented with multiple eruptive red-bluish raised papules and nodules distributed over the skin of the chin that were related to a papillary haemangioma.

Squillaci S
Olfactory neuroblastoma with focal ganglioneuroblastic differentiation: a case report with literature review.
Pathologica. 2014; 106(2):61-6 [PubMed] Related Publications
Olfactory neuroblastoma (ONB) is a rare malignant neuroectodermal tumour, with clearly defined histologic and immunohistochemical features, that typically arises in the superior nasal cavity. Although the classical clinicopathological features leave little room for misinterpretation, the wide variability in this tumour, including occasional divergent differentiation, may cause diagnostic difficulty. Herein, an unusual case of ONB with focal ganglioneuroblastic differentiation in an 81-year-old woman arising from the anterior ethmoid, filling the upper portion of the left nasal cavity and sparing the sinus cavities, is described. Histologically, the tumour was composed of atypical monotonous round cells that were positive for NSE, CD56, chromogranin, synaptophysin, neurofilament and calretinin and exhibited an irregular lobulated and nested growth pattern and sparse mitotic figures (3 to 4 mitoses per 10 HPF). Focally, the histology changed to ganglioneuroblastic differentiation consisting of large ganglion and spindle cells, positively staining for S-100, GFAP, CD99, neurofilament, calretinin, chromogranin and synaptophysin. Neuroblastomas, occurring in the nasal cavity, in analogy to other sites, tend to have an aggressive biologic behaviour and can histologically mimic other undifferentiated malignant neoplasms of the sinonasal tract. Differential diagnostic problems are discussed; a comprehensive review of the literature has also been performed with a focus on survival.

Roncati L, Pignatti E, Vighi E, et al.
Pre-miR146a expression in follicular carcinomas of the thyroid.
Pathologica. 2014; 106(2):58-60 [PubMed] Related Publications
INTRODUCTION: Micro-RNA, a new class of small, non-coding RNAs, have been shown to be deregulated in several human carcinomas. In particular, SNP rs2910164 in pre-miR146a appears to be correlated with papillary thyroid carcinoma and may be involved in its genetic predisposition. Since data on follicular thyroid carcinomas (FTC) are lacking, we evaluated the involvement of SNP rs2910164 in FTC.
METHODS: Thirty-nine cases of FTC and 20 follicular adenomas, defined according to WHO criteria, were selected. DNA and RNA were extracted from formalin-fixed paraffin-embedded blocks of both neoplastic and non-neoplastic areas. The DNA region of pre-miR146a, containing SNP rs2910164, was sequenced. Total RNA including miRNAs was used for stem-loop RT reactions, and applying a standard TaqMan PCR kit protocol for real-time PCR. Wilcoxon signed-rank test and Friedman test were used for statistical analyses.
RESULTS: In 31% of FTC, the G allele was observed in neoplastic tissues, compared with the non-neoplastic areas (p < 0.05), whereas the CC phenotype was completely absent in tumours. Moreover, the expression of pre-miR146a was found to be significantly down-regulated in neoplastic tissues from FTC cases (p = 0.043), although no significant differences were seen in follicular thyroid adenomas.
DISCUSSION: The expression profile of pre-miR146a can be correlated with FTC tumourigenesis. The G allele in SNP rs2910164 appears to be correlated with the transition from normal to neoplastic tissue. The GG and GC alleles appear to be associated with an increased risk for FTC, while the CC allele seems to play a protective role.

Related: Thyroid Cancer

Kordi-Tamandani DM, Saberi E, Jamali S, Ladiz MA
ERK and RAF1 genes: analysis of methylation and expression profiles in patients with oral squamous cell carcinoma.
Br J Biomed Sci. 2014; 71(3):100-3 [PubMed] Related Publications
The Ras/RAF/MEK/ERK1/2 pathway is important in the control of growth signals, differentiation and cell survival. Over-expression and activation of this pathway have been reported in different types of cancer. This study analyses the promoter methylation and RNA expression profiles of ERK and RAF1 genes with risk of oral squamous cell carcinoma (OSCC) along with the promoter methylation status of ERK and RAF1 genes using a methylation-specific polymerase chain reaction (MS-PCR) in 86 paraffin-wax embedded samples of OSCC and 68 normal control tissues. Furthermore, ERK and RAF1 expression was analysed in 19 cases and 20 normal samples by real-time reverse transcription PCR. Frequency of promoter methylation was detected for ERK (93.02% and 6.98%) and RAF1 (95.35% and 4.65%) genes in cases and controls, respectively. Messenger RNA (mRNA) expression analysis indicated statistically significant difference between cases and controls for ERK (P < 0.002) and RAF1 (P < 0.006). The authors believe that this is the first report to show that expression of ERK and RAF1 is involved in risk of OSCC.

Related: Oral Cancer

Esmer O, Karadag R, Bayramlar H, et al.
Bilateral lower eyelid basosquamous cell carcinoma: a rare case.
J Pak Med Assoc. 2014; 64(7):837-9 [PubMed] Related Publications
Basosquamous cell carcinoma is a subtype of basal cell cancer. It is known to be more aggressive than basal cell cancer. A 70-year-old male patient was admitted to our clinic for evaluation of cosmetic problems caused by masses on both lower eyelids for at least two years. The mass excision from and reconstruction of lower eyelids were performed. Histopathological examination of the resected masses was consistent with basosquamous cell carcinoma. We present a case of basosquamous cell carcinoma involving bilateral lower eyelids with a different clinical appearance. To the best of our knowledge, this is the first report of bilateral basosquamous cell carcinoma in a patient.

Related: Skin Cancer

Ma BY, Parajuly SS, Ying SX, Lan PY
Application of shear wave elastography in fine needle aspiration biopsy for thyroid nodule.
J Pak Med Assoc. 2014; 64(8):954-7 [PubMed] Related Publications
Ultrasound guided fine needle aspiration biopsy (FNAB) is the first-line procedure in diagnosing thyroid nodules. However, emerging studies have reported its unsatisfactory cell sample for cytology evaluation. In this case report, shear wave elastography (SWE) guided FNAB on a thyroid nodule is presented. Biopsies were performed on both hard and soft areas of the same nodule on the SWE image. Cytological results demonstrated the sufficient diagnostic components and typical nuclear features of papillary carcinoma found on the specimen from the hard area. This case study indicates SWE is a useful complementary tool to conventional B-mode ultrasound in guiding thyroid nodule FNAB.

Xu XR, Wang BR, Zhang Y, Jin ZG
Radiotherapeutic treatment of a fighter pilot with nasopharyngeal carcinoma.
Aviat Space Environ Med. 2014; 85(10):1056-60 [PubMed] Related Publications
BACKGROUND: Radiotherapy is the standard and most effective treatment for nasopharyngeal carcinoma (NPC) in its early stages. However, its application in fighter pilots returning to flying duties with NPC has not been previously reported, presumably due to post-radiotherapeutic complications.
CASE REPORT: A 36-yr-old male fighter pilot had a painless mass in the left neck for 5 mo. Pathological diagnosis demonstrated nonkeratinizing squamous cell carcinoma in the left nasopharynx which had metastasized to lymph nodes in the left side of the neck. He was diagnosed and staged with NPC (T1N2M0) before treatment with radiotherapy and adjuvant chemotherapy. The patient suffered from catarrhal otitis media and xerostomia after 3 mo of radiotherapy, but these symptoms resolved. After a total of 8 mo of radiotherapy, he was in remission with no evidence of tumor recurrence or metastasis. He had normal Eustachian tube, hearing, and vestibular function before and after hypobaric chamber testing and passed all flight-related physical examinations. Consequently, he was granted a medical waiver and returned to flying status in two-seat fighter aircraft, flying for 53 h in a 12-mo period. After passing all flight-related tests again, he was then allowed to fly in single-seat aircraft. At the time of submission of this article, he has flown for 147 h and remained on flying status for 26 mo. He will be monitored annually for long-term effects of radiotherapy and/or disease recurrence.
CONCLUSIONS: Fighter pilots with NPC may be safely considered for medical waiver with appropriate monitoring after successful treatment.

Related: Nasopharyngeal Cancer

Gupta N, Wadhwa N, Goyal A
Tuberculosis of nasopharynx masquerading as angiofibroma.
Indian J Tuberc. 2014; 61(3):250-3 [PubMed] Related Publications
Nasopharyngeal tuberculosis is a rare entity. We present a case of nasopharyngeal tuberculosis in an adolescent male which masqueraded as angiofibroma because of its clinical presentation and radiological features. Histopathology played a critical role in proper management of the case. We report this case because of its atypical presentation and clinical rarity.

Related: Nasopharyngeal Cancer

Beggan C, Davies K, Leader M
Juxta-articular myxoma: an unusual benign mesenchymal lesion, readily mistaken for malignancy.
Ir Med J. 2014 Jul-Aug; 107(7):212-3 [PubMed] Related Publications
Myxomas are benign tumours of mesenchymal origin. We describe the first reported case of paraspinal juxta-articular myxoma. Juxta-articular myxomas show increased cellularity and distinction from cellular myxoma is required. The differential also includes malignant myxofibrosarcoma. For patient prognosis and management it is essential to separate these entities. Complete surgical excision is the mainstay of treatment as local recurrences may occur.

Agha-Hosseini F, Moslemi E
Angiofibrolipoma of the retromolar pad region: case report.
N Y State Dent J. 2014 Jun-Jul; 80(4):33-7 [PubMed] Related Publications
Angiofibrolipoma is a rare histopathological variant of lipoma, characterized by mature adipocytes, blood vessels and dense collagenous tissue. It is seldom seen in the oral and maxillofacial region. Diagnosis of angiofibrolipoma is only possible based on its histopathological features. This report presents the case of a 63-year-old male patient with the complaint of a polyp-like mass, felt from the left retromolar pad region. The mass was found as a small prominent lesion that had grown gradually for 1.5 years. Our differential diagnosis was irritation fibroma and fibrous pyogenic granuloma. This report also includes a comprehensive reference to previously reported data, as found through PubMed and Google Search, which revealed this type of case rarely has been documented.

Santini F, Marzullo P, Rotondi M, et al.
Mechanisms in endocrinology: the crosstalk between thyroid gland and adipose tissue: signal integration in health and disease.
Eur J Endocrinol. 2014; 171(4):R137-52 [PubMed] Related Publications
Obesity and thyroid diseases are common disorders in the general population and they frequently occur in single individuals. Alongside a chance association, a direct relationship between 'thyroid and obesity' has been hypothesized. Thyroid hormone is an important determinant of energy expenditure and contributes to appetite regulation, while hormones and cytokines from the adipose tissue act on the CNS to inform on the quantity of energy stores. A continuous interaction between the thyroid hormone and regulatory mechanisms localized in adipose tissue and brain is important for human body weight control and maintenance of optimal energy balance. Whether obesity has a pathogenic role in thyroid disease remains largely a matter of investigation. This review highlights the complexity in the identification of thyroid hormone deficiency in obese patients. Regardless of the importance of treating subclinical and overt hypothyroidism, at present there is no evidence to recommend pharmacological correction of the isolated hyperthyrotropinemia often encountered in obese patients. While thyroid hormones are not indicated as anti-obesity drugs, preclinical studies suggest that thyromimetic drugs, by targeting selected receptors, might be useful in the treatment of obesity and dyslipidemia.

Related: Thyroid Cancer

DiGangi P
Oral precancer and the HPV connection.
Dent Assist. 2014 Jul-Aug; 83(4):16, 18, 20-2 passim [PubMed] Related Publications
All dental care professionals need to educate themselves and their patients about the relationship between oropharyngeal cancers, HPV, and risk factor management. A risk factor manager is an early interventionist whose tasks are performing diagnostic testing, gathering data, and putting it into a meaningful report for the care providers. Risk factor managers practice on all three levels of prevention, including proactively identifying risks for oral precancer with the hope of changing our dread predictions.

Related: Cancer Screening and Early Detection Oral Cancer

Likhtarov I, Kovgan L, Masiuk S, et al.
Thyroid cancer study among Ukrainian children exposed to radiation after the Chornobyl accident: improved estimates of the thyroid doses to the cohort members.
Health Phys. 2014; 106(3):370-96 [PubMed] Article available free on PMC after 01/03/2015 Related Publications
In collaboration with the Ukrainian Research Center for Radiation Medicine, the U.S. National Cancer Institute initiated a cohort study of children and adolescents exposed to Chornobyl fallout in Ukraine to better understand the long-term health effects of exposure to radioactive iodines. All 13,204 cohort members were subjected to at least one direct thyroid measurement between 30 April and 30 June 1986 and resided at the time of the accident in the northern parts of Kyiv, Zhytomyr, or Chernihiv Oblasts, which were the most contaminated territories of Ukraine as a result of radioactive fallout from the Chornobyl accident. Thyroid doses for the cohort members, which had been estimated following the first round of interviews, were re-evaluated following the second round of interviews. The revised thyroid doses range from 0.35 mGy to 42 Gy, with 95% of the doses between 1 mGy and 4.2 Gy, an arithmetic mean of 0.65 Gy, and a geometric mean of 0.19 Gy. These means are 70% of the previous estimates, mainly because of the use of country-specific thyroid masses. Many of the individual thyroid dose estimates show substantial differences because of the use of an improved questionnaire for the second round of interviews. Limitations of the current set of thyroid dose estimates are discussed. For the epidemiologic study, the most notable improvement is a revised assessment of the uncertainties, as shared and unshared uncertainties in the parameter values were considered in the calculation of the 1,000 stochastic estimates of thyroid dose for each cohort member. This procedure makes it possible to perform a more realistic risk analysis.

Related: Thyroid Cancer

Vrndic OB, Radivojevic SD, Jovanovic MD, et al.
Oxidative stress in patients with differentiated thyroid cancer: early effects of radioiodine therapy.
Indian J Biochem Biophys. 2014; 51(3):223-9 [PubMed] Related Publications
Ionizing radiation in differentiated thyroid cancer (DTC) patients treated with radioiodine (131-I) produces reactive oxygen species (ROS), which could induce oxidative stress with disturbance of redox balance. The aim of this study was to evaluate oxidative stress in DTC patients treated with 3.7 or 5.5 GBq of 131-I using values for serum malondialdehyde (MDA, a marker of oxidative stress), uric acid (to determine antioxidant status) and total antioxidative status (TAS). The study population included 20 DTC patients and 20 healthy controls. Significant differences in MDA concentrations were found between DTC patients before 131-I therapy and control subjects (p = 0.001), while TAS values were similar in both populations (p > 0.05). There was a negative correlation between MDA concentrations and TAS in the DTC group before therapy (R2 = 0.2973, p = 0.013). Three days after 131-I therapy, MDA concentrations were higher than the pretreatment values (3.36 +/- 1.69 nmol/mL vs. 2.93 +/- 1.31 nmol/mL; p = 0.006), while serum uric acid concentrations declined progressively from 341.0 +/- 80.39 micromol/L to 304.25 +/- 77.25 micromol/L (p = 0.026) in 3 days and 291.2 +/- 88.86 micromol/L (p = 0.009) in 7 days after 131-I therapy. There was no dose-dependent effect on MDA, or uric acid concentrations and TAS. Thus, 131-I therapy in DTC patients induced oxidative stress, which was accompanied by a simultaneous and extended reduction in uric acid concentration, but without significant disturbances in TAS. This is the first study that evaluated TAS capacity in DTC patients before and 7 days after 131-I therapy. The relatively stabile TAS values in these patients indicated a good protection from oxidative stress induced by high doses of ionizing radiation.

Related: Thyroid Cancer

Adam MA, Pura J, Gu L, et al.
Extent of surgery for papillary thyroid cancer is not associated with survival: an analysis of 61,775 patients.
Ann Surg. 2014; 260(4):601-5; discussion 605-7 [PubMed] Related Publications
OBJECTIVE: To examine the association between the extent of surgery and overall survival in a large contemporary cohort of patients with papillary thyroid cancer (PTC).
BACKGROUND: Guidelines recommend total thyroidectomy for PTC tumors >1 cm, based on older data demonstrating an overall survival advantage for total thyroidectomy over lobectomy.
METHODS: Adult patients with PTC tumors 1.0-4.0 cm undergoing thyroidectomy in the National Cancer Database, 1998-2006, were included. Cox proportional hazards models were applied to measure the association between the extent of surgery and overall survival while adjusting for patient demographic and clinical factors, including comorbidities, extrathyroidal extension, multifocality, nodal and distant metastases, and radioactive iodine treatment.
RESULTS: Among 61,775 PTC patients, 54,926 underwent total thyroidectomy and 6849 lobectomy. Compared with lobectomy, patients undergoing total thyroidectomy had more nodal (7% vs 27%), extrathyroidal (5% vs 16%), and multifocal disease (29% vs 44%) (all Ps < 0.001). Median follow-up was 82 months (range, 60-179 months). After multivariable adjustment, overall survival was similar in patients undergoing total thyroidectomy versus lobectomy for tumors 1.0-4.0 cm [hazard ratio (HR) = 0.96; 95% confidence interval (CI), 0.84-1.09); P = 0.54] and when stratified by tumor size: 1.0-2.0 cm [HR = 1.05; 95% CI, 0.88-1.26; P = 0.61] and 2.1-4.0 cm [HR = 0.89; 95% CI, 0.73-1.07; P = 0.21]. Older age, male sex, black race, lower income, tumor size, and presence of nodal or distant metastases were independently associated with compromised survival (P < 0.0001).
CONCLUSIONS: Current guidelines suggest total thyroidectomy for PTC tumors >1 cm. However, we did not observe a survival advantage associated with total thyroidectomy compared with lobectomy. These findings call into question whether tumor size should be an absolute indication for total thyroidectomy.

Related: Thyroid Cancer

Tosheva E, Yonkov A, Stojanov V, et al.
Clinical case of neuroendocrine malignant tumor with unusual localization in the adrenal cortex.
Khirurgiia (Sofiia). 2014; (1):39-42 [PubMed] Related Publications
The authors present unusual clinical case with atypical diagnostic work-up and histological result of adrenal neuroendocrine carcinoma.

Related: Adrenocortical Cancer Adrenocortical Carcinoma - Molecular Biology

Diegidio P, Kolok D, Brown W, Camps JI
Papillary thyroid cancer in identical adolescent twins with osteogenesis imperfecta and Hashimoto's thyroiditis: is there a genetic link?
Am Surg. 2014; 80(9):849-50 [PubMed] Related Publications
The relationship between Hashimoto's thyroiditis (HT) and papillary thyroid cancer (PTC) remains controversial. Researchers have identified multiple genes that could put patients with HT at risk for PTC. None are related to osteogenesis imperfecta (OI). We present identical twin sisters with OI who developed PTC in the setting HT.

Related: Thyroid Cancer

Kordes S, van Berge Henegouwen MI, Hulshof MC, et al.
Preoperative chemoradiation therapy in combination with panitumumab for patients with resectable esophageal cancer: the PACT study.
Int J Radiat Oncol Biol Phys. 2014; 90(1):190-6 [PubMed] Related Publications
PURPOSE: Preoperative chemoradiation therapy (CRT) has become the standard treatment strategy for patients with resectable esophageal cancer. This multicenter phase 2 study investigated the efficacy of the addition of the epidermal growth factor receptor (EGFR) inhibitor panitumumab to a preoperative CRT regimen with carboplatin, paclitaxel, and radiation therapy in patients with resectable esophageal cancer.
METHODS AND MATERIALS: Patients with resectable cT1N1M0 or cT2-3N0 to -2M0 tumors received preoperative CRT consisting of panitumumab (6 mg/kg) on days 1, 15, and 29, weekly administrations of carboplatin (area under the curve [AUC] = 2), and paclitaxel (50 mg/m(2)) for 5 weeks and concurrent radiation therapy (41.4 Gy in 23 fractions, 5 days per week), followed by surgery. Primary endpoint was pathologic complete response (pCR) rate. We aimed at a pCR rate of more than 40%. Furthermore, we explored the predictive value of biomarkers (EGFR, HER 2, and P53) for pCR.
RESULTS: From January 2010 until December 2011, 90 patients were enrolled. Patients were diagnosed predominantly with adenocarcinoma (AC) (80%), T3 disease (89%), and were node positive (81%). Three patients were not resected due to progressive disease. The primary aim was unmet, with a pCR rate of 22%. Patients with AC and squamous cell carcinoma reached a pCR of 14% and 47%, respectively. R0 resection was achieved in 95% of the patients. Main grade 3 toxicities were rash (12%), fatigue (11%), and nonfebrile neutropenia (11%). None of the biomarkers was predictive for response.
CONCLUSIONS: The addition of panitumumab to CRT with carboplatin and paclitaxel was safe and well tolerated but could not improve pCR rate to the preset criterion of 40%.

Related: Monoclonal Antibodies Carboplatin Cancer of the Esophagus Esophageal Cancer Paclitaxel Panitumumab (Vectibix)

Razavi SM, Khalesi S, Torabinia N
Investigation of clinicopathological parameters alongside with p53 expression in primary and recurrent keratocysticodontogenic tumours.
Malays J Pathol. 2014; 36(2):105-13 [PubMed] Related Publications
BACKGROUND: Keratocysticodontogenic tumor (KCOT) is one of the most common odontogenic cysts and has a high recurrence rate after various treatment methods. Some studies have been conducted to identify the predictive factors of recurrence. In this study, the clinicopathological and immunohistochemical features of primary and recurrent KCOTs are analyzed, including immunohistochemically expression of p53 protein in cyst-lining epithelial cells in order to find more markers to predict the specific behaviour and greater tendency for recurrence.
METHODS: In this descriptive analytic study, a total of 78 archived specimens of KCOTs, including 52 primary KCOT with no registered recurrences to date and 26 recurrent KCOT were selected. The clinical data and histopathological features of the epithelial lining and connective tissue wall were analyzed. Immuonohistochemical staining intensity distribution (SID) score for p53-positive cells were calculated for both groups. Results were analyzed by T-test, Chi-square, and Fisher's exact test.
RESULTS: There were no statistically significant differences between primary and recurrent cases in terms of age (P = 0.181), gender (P = 0.744), and anatomical location (P = 0.294). In the histopathological assessment, epithelial budding (P = 0.001), daughter cysts (P = 0.013), and odontogenic rests (P = 0.036) were significantly more common in recurrent KCOTs. Immunohistochemical staining for p53 show statistically significant difference between the two groups (P = 0.041).
CONCLUSION: In this study, some predictive factors of recurrence of KCOTs such as epithelial budding, daughter cyst and odontogenic rests were found. Furthermore, the evaluation of p53 expression in KCOT at the time of diagnosis was helpful for the prediction of recurrence.

Related: Oral Cancer TP53

Zhao G, Dong C, Yang M, et al.
Totally thoracoscopic tracheoplasty for a squamous cell carcinoma of the mediastinal trachea.
Ann Thorac Surg. 2014; 98(3):1109-11 [PubMed] Related Publications
This report describes the first totally thoracoscopic tracheoplasty for a squamous cell carcinoma at the mediastinal trachea. The surgical procedure was conducted with five access incisions. A segment of the trachea was resected circumferentially, and the tracheal stumps were joined by an end-to-end anastomosis. The patient recovered rapidly and was discharged on the 12th postoperative day.

Related: Tracheal (windpipe) Cancer

Chen W, Yang C, Yang L, et al.
Association of roasting meat intake with the risk of esophageal squamous cell carcinoma of Kazakh Chinese via affecting promoter methylation of p16 gene.
Asia Pac J Clin Nutr. 2014; 23(3):488-97 [PubMed] Related Publications
BACKGROUND: Esophageal squamous cell carcinoma (ESCC) incidence is high in Kazak Autonomous Prefecture, Xinjiang, China. Roasting food has been reported to be related with the risk of various cancers and is very popular in the area, and may be related with the risk of ESCC. The promoter methylation inactivation of p16 gene can increase the risk of ESCC. Thus, we want to know whether long-term roasting food is related with the risk of ESCC by effecting the promoter methylation of p16 gene.
MATERIALS AND METHODS: Ninety ESCC patients and 60 healthy subjects were recruited from Kazak Autonomous Prefecture. MassARRAY was used to detect p16 promoter methylation in ESCC tissues, as well as in normal esophageal tissues. The association between the p16 promoter methylation and daily roasting meat intake was examined.
RESULTS: Daily roasting meat intake was related with the risk of ESCC (p<0.01) and the mean CpG methylation rates of p16 promoter (p<0.01). In ESCC patients, the mean methylation rates of CpG 11-12 and CpG 33-34-35 were 29.4% and 37.4%, respectively, which was significantly higher than the rates in normal esophageal tissues (16.7% and 12.4%, respectively; p<0.01). The methylation of p16 promoter is also related with daily roasting meat intake (p<0.01) in Kazakh Chinese with ESCC. For the CpG methylation of the p16 promoter in the well, moderately and poorly differentiated ESCC, there are significant differences (p<0.05) for the 19 CpG units in the ESCC and controls.
CONCLUSION: Roasting meat intake was associated with the risk of ESCC via effects on the methylation of p16 promoter. These results suggest roasting food intake should be limited in the diet.

Related: Cancer of the Esophagus Esophageal Cancer CDKN2A

Milenović A, Boras VV, Ilić I, et al.
Simultaneous presentation of oral and skin anaplastic large T-cell lymphoma.
Acta Clin Croat. 2014; 53(2):246-51 [PubMed] Related Publications
We present case of oral and skin anaplastic T-cell lymphoma in a 68-year-old woman. The patient presented with extensive ulcerations and necrotic tissue on the left mandibular gingiva. Orthopantomogram finding showed extensive necrolytic lesions of the adjacent mandible. Biopsy finding of oral lesions and subsequently of the skin confirmed the diagnosis of anaplastic T-cell lymphoma. The bridge on the teeth 35-37 was taken out. After three cycles of chemotherapy, oral lesions subsided, unlike skin lesions. Dentists should be aware that differential diagnosis when dealing with oral ulcerations might be the result of certain malignant hematologic diseases.

Related: Oral Cancer Skin Cancer

Humphreys TR
Repair of the medial canthus following Mohs micrographic surgery.
Dermatol Surg. 2014; 40 Suppl 9:S96-S102 [PubMed] Related Publications
BACKGROUND: The medial canthus poses unique reconstructive challenges because of its anatomy and contour. The reconstructive goal should be preservation of the natural concavity that defines it because even small alterations can result in perceptible asymmetry.
OBJECTIVE: To present the anatomy of this unique cosmetic subunit and review reconstructive options that preserve contour and function.
MATERIALS AND METHODS: A variety of reconstructive approaches for different subunits of the medial canthus are described and discussed. Technical considerations and complications are discussed.
RESULTS: The choice of repair will depend on the relative location of the defect on the medial canthus and the proximity to adjacent cosmetic subunits.
CONCLUSION: Understanding of the unique contour and anatomy of the medial canthus is essential to choosing the best repair option that preserves contour and symmetry.

Related: Basal Cell Carcinoma Skin Cancer

Manolidis S, Ratner D
External auditory canal defect management and reconstruction.
Dermatol Surg. 2014; 40 Suppl 9:S86-95 [PubMed] Related Publications
BACKGROUND: The external auditory canal (EAC) is an area commonly involved by skin cancers. Knowledge of the anatomy of this area and proper evaluation and management of patients with these malignancies is essential.
OBJECTIVE: The purpose of this article is to provide the reader with an understanding of the anatomy of the EAC, the options available for the treatment of EAC cancers, and repair of the resulting surgical defects.
METHODS AND MATERIALS: A review of the current literature was performed to summarize the current literature on this topic.
RESULTS: There are a variety of surgical options available for the treatment of these cancers whose use depends on the location and extent of the tumor. It is important to follow a logical reconstructive algorithm after tumor resection to optimize both functional and cosmetic results.

Related: Skin Cancer

Goldman GD
Reconstruction of the nasal infratip, columella, and soft triangle.
Dermatol Surg. 2014; 40 Suppl 9:S53-61 [PubMed] Related Publications
BACKGROUND: Tumors of the soft triangle and distal nose are common, and the wounds created when removing them are among the more challenging defects to repair.
OBJECTIVE: Reconstruction of the soft triangle, infratip, and columella requires attention to form and function beyond what is usually needed in cutaneous surgery. The complexities of the anatomy demand meticulous planning and surgical execution. In this review, the goal is to provide the cutaneous surgeon with a logical approach to repair this challenging region.
METHODS: Skin grafts, composite grafts, local flaps, and pedicle flaps are presented with pearls and pointers. Cartilage grafting for stability is reviewed and detailed. A step-by-step approach allows the surgeon to plan appropriately and execute repairs with excellence.
RESULTS: Ten cases are reviewed in sequential photo format to demonstrate successful reconstruction of operative wounds from this challenging region of the nose.
CONCLUSION: The most distal nasal contours pose many challenges for reconstruction. Success depends on a good knowledge of anatomy, rigorous planning, and superior surgical skills. Skin grafts, composite grafts, local and interpolated flaps are all options that need to be considered when recreating the delicate folds and contours of this region. Cartilage support may be needed to maintain structural integrity. With care, excellent outcomes are predictably achieved.

Cook JL
Tunneled and transposed island flaps in facial reconstructive surgery.
Dermatol Surg. 2014; 40 Suppl 9:S16-29 [PubMed] Related Publications
BACKGROUND: Surgical wounds on the central face present reconstructive challenges given the aesthetic prominence of these visually important areas and a general lack of local tissue availability.
MATERIALS AND METHODS: Illustrative case examples demonstrate the potential clinical utility of nontraditional island flaps that are tunneled or transposed into operative defects.
RESULTS: Aesthetically successful reconstruction of difficult facial wounds was accomplished with island flaps that used less traditional operative designs.
CONCLUSION: When designed and executed properly, island flaps offer unrivaled opportunities to reconstruct the face with maximal preservation of central facial symmetry.

Related: Basal Cell Carcinoma Skin Cancer

Lee WW, Erickson BP, Ko MJ, et al.
Advanced single-stage eyelid reconstruction: anatomy and techniques.
Dermatol Surg. 2014; 40 Suppl 9:S103-12 [PubMed] Related Publications
BACKGROUND: Skin cancers of the periocular tissue present formidable reconstructive challenges because of anatomic complexity, vital function, and cosmetic significance.
OBJECTIVE: To review eyelid anatomy and reconstructive techniques from an oculoplastic surgery perspective.
RESULTS: Eyelid structure and function are intimately linked, and good working knowledge is a prerequisite for successful reconstructive efforts. We discuss periocular anatomy, patient evaluation, and single-stage repair of both anterior lamellar and full-thickness defects.
CONCLUSION: Despite the challenges of periocular skin cancer reconstruction, excellent cosmetic and functional results can be achieved with appropriate technique.

Related: Skin Cancer

Machida S, Ohguro H, Ishida K, et al.
Recoverin-associated retinopathy secondary to Warthin tumor of parotid gland.
Doc Ophthalmol. 2014; 129(2):123-8 [PubMed] Related Publications
PURPOSE: To present a case of photoreceptor degeneration associated with a benign Warthin tumor of the parotid gland.
CASE REPORT: A 57-year-old man visited our clinic complaining of blurred vision in both eyes. His best-corrected visual acuity was 0.07 in the right and 0.04 in the left eyes. All components of the full-field electroretinograms (ERGs) were reduced in both eyes. The focal macular ERGs were extinguished in both eyes, which was consistent with the deterioration of the outer retina in optical coherence tomographic images. Positron emission tomography showed (18)F-fluorodeoxy glucose accumulation in the left parotid gland. Parotidectomy was performed, and the histopathology of the specimen had features compatible with a Warthin tumor without malignancy. Western blot analysis of the patient's sera detected an antibody against recoverin. In addition, the tumor tissue had an aberrant expression of recoverin.
CONCLUSION: The findings in this case indicate that recoverin-associated retinopathy can develop secondary to a benign Warthin tumor.

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